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| Name | Class |
|---|---|
| Seoul National University Hospital | OTHER |
| Ulsan University Hospital | OTHER |
| Inje University Ilsan Paik Hospital | OTHER |
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Natural course of intermediate coronary artery disease (CAD) is very important to predict the prognosis of the patient with such disease.
Several studies have well demonstrated the beneficial effect of lipid-lowering therapy on the progression of CAD with the modification of lipid profiles.
This effect can be also explained by intravascular ultrasound (IVUS) or optical coherence tomography. However, the effect of plaque modification on coronary physiology has been rarely evaluated.
This research is to evaluate the change of intermediate or nonculprit coronary lesion on lipid-lowering therapy via IVUS(optional) and FFR.
The patients who have intermediate CAD (30-80% diameter stenosis by visual estimation) with FFR≥0.80, or nonculprit coronary artery disease with FFR≥0.8 after culprit coronary artery disease intervention will be enrolled. FFR, IVUS(optional) and index of microcirculatory resistance (IMR) should be performed simultaneously. Atorvastatin 20mg is a starting dose, then up-titration will be done twice within each 4~6weeks until LDL target goal (①LDL<70mg/dl, or ② statin naive: >50% reduction from baseline LDL, current statin user: >30% reduction from baseline LDL). First titration will be atorvastatin 40mg, second will be atorvastatin 80mg. If patients have any adverse effect on atorvastatin, the dose of atorvastatin can be adjusted by investigator's decision. Official clinical follow-up except visit for statin dose titration will occur at 1, 12 months after index procedure. Follow-up coronary angiography, FFR,IMR,and IVUS(optional) will be performed 12 months after index procedure.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Atorvastatin | Experimental | Atorvastatin (Lipitor) will be prescribed with 20mg,40mg,or 80mg by the unit of 28 tablets upon the result of lipid profile. Besides Clinical and lab test, follow-up CAG, IVUS(optional) and FFR will be performed in 12 months. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Atorvastatin | Drug | Lipitor dose titration will be followed by the result of LDL lab test until it meets the target level of LDL. IVUS(optional) and FFR during follow up CAG in 12 months will be measured to evaluate the effect of lipitor. |
| Measure | Description | Time Frame |
|---|---|---|
| changes of FFR between baseline and 12months follow-up | changes of FFR(fractional flow reserve) baseline and 12month foloow-up | up to 1 year |
| Measure | Description | Time Frame |
|---|---|---|
| Change of FFR according to the degree of decreased LDL | Change of FFR according to the degree of decreased LDL | up to 1 year |
| Change of % plaque volume, total atheroma volume & plaque compositions in lesion of interest |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Chang-Wook Nam, Postdoctoral | Keimyung University Dongsan Medical Center | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Ulsan University Hospital | Ulsan | Gyeongsangbuk-do | South Korea | |||
| Inje University Ilsan Paik Hospital |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 36444331 | Derived | Lee CH, Hwang J, Kim IC, Cho YK, Park HS, Yoon HJ, Kim H, Han S, Hur SH, Kim KB, Kim JY, Chung JW, Lee JM, Doh JH, Shin ES, Koo BK, Nam CW. Effect of Atorvastatin on Serial Changes in Coronary Physiology and Plaque Parameters. JACC Asia. 2022 Nov 1;2(6):691-703. doi: 10.1016/j.jacasi.2022.07.010. eCollection 2022 Nov. |
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| ID | Term |
|---|---|
| D003324 | Coronary Artery Disease |
| ID | Term |
|---|---|
| D003327 | Coronary Disease |
| D017202 | Myocardial Ischemia |
| D006331 | Heart Diseases |
| D002318 | Cardiovascular Diseases |
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| ID | Term |
|---|---|
| D000069059 | Atorvastatin |
| ID | Term |
|---|---|
| D011758 | Pyrroles |
| D001393 | Azoles |
| D006573 | Heterocyclic Compounds, 1-Ring |
| D006571 | Heterocyclic Compounds |
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Change of % plaque volume, total atheroma volume & plaque compositions in lesion of interest
| up to 1 year |
| Change of IMR | Change of IMR(index of microcirculatory resistance) | up to 1 year |
| Death including cardiac and noncardiac | Death including cardiac and noncardiac | up to 1 year |
| Myocardial infarction | Myocardial infarction | up to 1 year |
| Target lesion and vessel revascularization rate | Target lesion and vessel revascularization rate | up to 1 year |
| CVA: hemorrhage and infarction | CVA(cerebrovascular accident): hemorrhage and infarction | up to 1 year |
| side effect of statin : liver and muscle enzyme | side effect of statin : liver and muscle enzyme | up to 1 year |
| Ilsan |
| Kyeongki |
| South Korea |
| Keimyung University Dongsan Medical center | Daegu | South Korea |
| Seoul National University Hospital | Seoul | South Korea |
| D001161 |
| Arteriosclerosis |
| D001157 | Arterial Occlusive Diseases |
| D014652 | Vascular Diseases |
| D006538 |
| Heptanoic Acids |
| D005227 | Fatty Acids |
| D008055 | Lipids |